md16510a - ispor us poster medtronic v2.0

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  • IntroductionCluster headache is a devastating primary headache, characterized by attacks of severe, strictly unilateral pain which is orbital, supraorbital and/or temporal, lasting between 15 to 180 minutes when untreated. The attacks occur almost every other day, up to 8 times a day. Chronic cluster headache (CCH) is a type of cluster headache in which attacks occur for more than a year without remission or with remission periods lasting less than 1 month (1). The clinical characteristics of CCH suggest a substantial disease burden, both to patients as well as society. We aim to provide an overview of the disease burden of CCH and outcomes of treatments recommended by the European Federation of Neurological Societies (EFNS) for CCH (2).

    Two research questions were designed:

    1) What evidence is reported in the literature with regard to epidemiological, economic, and humanistic burden and comorbidities for CCH?

    2) What evidence is reported in the literature with regard to economic burden, complications and outcomes for treatments recommended in the EFNS guidelines?

    MethodsA predefined search strategy was used to search Medline, Embase, Econlit, Cochrane and NHS EED databases for citations published from the year 2000 and onwards. The search was performed on May 27th 2014. Identification of relevant citations was based on PICOS criteria (Table 1). Data was extracted using data extraction forms; one researcher extracted the data and a second independent researcher checked each extraction. Details on study design (e.g. study objective, case finding method, inclusion criteria); patient characteristics (e.g. age, gender, number of CCH patients) and outcomes (e.g. prevalence, humanistic burden, treatment efficacy) were extracted.

    Table 1 PICOS criteria

    Question 1 Question 2

    Population Inclusion criteria

    Adult patients (18 years)Chronic Cluster headache according to ICHD-III beta criteria:A. At least five attacks fulfilling criteria BDB. Severe or very severe unilateral orbital, supraorbital and/or

    temporal pain lasting 15180 minutes (when untreated)C. Either or both of the following:

    At least one of the following symptoms or signs, ipsilateral to the headache:- conjunctival injection and/or lacrimation- nasal congestion and/or rhinorrhoea- eyelid edema- forehead and facial sweating- forehead and facial flushing- sensation of fullness in the ear- miosis and/or ptosis

    A sense of restlessness or agitationD. Attacks have a frequency between one every other day and

    eight per day for more than half of the time when the disorder is active

    E. Not attributed to another ICHD-3 diagnosisF. Occurring without a remission period, or with remissions lasting